Blood, 1 February 2008, Vol. 111, No. 3, pp. 989-996.
Prepublished online as a Blood First Edition Paper on September 18, 2007; DOI 10.1182/blood-2007-06-096594.
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PLENARY PAPER
Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years
Karen L. Syrjala1,2,
Brenda F. Kurland1,
Janet R. Abrams1,
Jean E. Sanders1,3, and
Julia R. Heiman2,4,6
1 Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA;
2 Department of Psychiatry and Behavioral Sciences and
3 Department of Medicine and Pediatrics, University of Washington School of Medicine, Seattle;
4 Kinsey Institute for Research in Sex, Gender, and Reproduction,
5 Department of Psychological and Brain Sciences, and
6 Department of Clinical Psychiatry, Indiana University, Bloomington
This prospective study evaluated sexual function through 5 years after myeloablative allogeneic hematopoietic cell transplantation (HCT) for cancer to determine sexual function recovery and residual problems. Adults completed measures before HCT (N = 161), with survivors followed at 6 months and at 1, 2, 3, and 5 years. At 5 years case-matched controls also completed assessments. Analyses indicated that men and women differed in rates of being sexually active across time (P < .001) and in overall sexual function (P < .001). Both sexes declined in sexual activity rates and sexual function from before HCT to 6 months afterward (P .05). Activity rates recovered for men by 1 year (74%) and for women by 2 years (55%). Men improved from their 6-month nadir in sexual function by 2 years (P = .02), whereas women did not improve by 5 years (P = .17). Both male and female survivors were below controls in rates of sexual activity and sexual function at 5 years. Most women reported sexual problems (80% of survivors vs 61% of controls, P = .11); in contrast for men 46% of survivors versus 21% of controls (P = .05) reported problems. Thus, despite some recovery, sexual dysfunction remained a major problem for men and women after HCT. Aggressive efforts are needed to treat these deficits.

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